运动心电图与运动心电图在怀疑冠状动脉疾病的女性中的比较有效性:一项随机研究
Sothinathan Gurunathan1,2,3, Mayooran Shanmuganathan1, Ankur Chopra1
1Department of Cardiology, Northwick Park Hospital, Harrow, UK.
European heart journal open
|June 12, 2023
概括
运动心电图 (Ex-ECG) 的诊断价值与运动压力心电图 (ESE) 的诊断价值相似,用于检测女性冠状动脉疾病 (CAD). 外电图导致了更高的资源使用,但也节省了成本.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 预防医学 预防医学
背景情况:
- 在女性中冠状动脉疾病 (CAD) 诊断缺乏强大的随机研究.
- 评估可疑CAD的非侵入性诊断策略至关重要.
研究的目的:
- 为了比较运动应激回声心电图 (ESE) 与运动心电图 (Ex-ECG) 的诊断准确度和资源利用率,在怀疑CAD的女性中.
- 评估与每个诊断方法相关的积极预测值 (PPV) 和下游医疗保健成本.
主要方法:
- 一项随机研究涉及416名女性,她们在测试前有中等的CAD概率.
- 参与者被分配到Ex-ECG或ESE进行诊断评估.
- 主要终点包括显著CAD和资源利用的PPV.
主要成果:
- 检测CAD的PPV在ESE (33%) 和Ex-ECG (30%) 之间是类似的.
- 下游资源利用率在Ex-ECG部门更高,尽管初始诊断成本较低.
- 心脏事件是可比的,在2.9年内,Ex-ECG组有6次,ESE组有3次.
结论:
- 在能够运动的中等风险女性中,Ex-ECG在CAD检测方面表现出与ESE相似的有效性.
- 退出ECG策略导致了更高的资源利用率,但导致了整体成本节省.
- 在Ex-ECG和ESE之间的选择可能取决于医疗保健系统的成本和资源的可用性.
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